Atrial fibrillation with rapid ventricular response in pregnancy.
OBJECTIVE
To report a case of atrial fibrillation with rapid ventricular response occurring during pregnancy.


METHODS
A 35-year-old woman, gravida 3, para 1, abortus 1, with a history of persistent supraventricular arrhythmia, presented at 22 weeks' gestation. After adenosine administration, electrocardiography revealed atrial fibrillation with rapid ventricular response. The episode was complicated by hemodynamic instability and was refractory to verapamil. Sinus rhythm was restored after synchronized electrical cardioversion under sedation. Sotalol (80 mg) was given for arrhythmia and to control heart rate. The patient experienced a second episode of supraventricular arrhythmia at 26 weeks' gestation, which was also reversed after cardioversion. She delivered a healthy male baby at 38 weeks' gestation via scheduled cesarean section.


CONCLUSIONS
Arrhythmias with underlying heart disease can result in serious hemodynamic deterioration. Electrical cardioversion is well-tolerated and effective in pregnant women and should not be withheld if clinically indicated.
Lin
Chia-Hui
CH
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
Lee
Chien-Nan
CN
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000628:therapy*; D002585:Cesarean Section; D003131:Combined Modality Therapy; D004554:Electric Countershock / Q000379:methods; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000628:therapy*; D011256:Pregnancy Outcome; D018570:Risk Assessment; D012720:Severity of Illness Index
D000889:Anti-Arrhythmia Agents